失效模式与效应分析在院前喉罩建立气道中的应用

The application of failure mode and effects analysis in the pre-hospitallaryngeal mask implant

目的探讨失效模式与效应分析(failure mode and effects analysis,FMEA)在院前喉罩置入中的应用与效果。方法收集院前急救中需行紧急人工气道建立的患者共80例,对照组39例,按常规方法进行人工气道建立并运用FMEA对院前急救喉罩插入过程中可能出现的插管失败原因进行潜在风险分析制定改进措施;将该措施运用于观察组41例患者,改进喉罩置入流程。比较两组首次喉罩置入成功率和平均操作时间。结果观察组的喉罩首次插入成功率95.1%明显高于对照组的76.9%;平均操作时间(28.1±4.2)秒,P<0.05秒明显少于对照组的(33.8±3.9),P<0.01。结论 FMEA应用于院前喉罩置入明显提高首次置管成功率,并缩短操作时间。

Objective To investigate theapplication and effect of failure mode and effect analysis （FMEA） in the pre-hospitallaryngeal mask implant. Methods 80 cases of pre-hospital patients acquiring artificial-airway establishment were enrolled in the study. Conventional method of laryngeal mask insertion was used toset up artificial-airway for patients in control group （ n = 39）. Assess the risk of failure of conventional method, explore an improvement measure and applyit in the procedure in laryngeal mask insertion for patients in observation group（ n = 41 ）. To respectively compare therate of first-time success and the average operation time cost in artificial-airway set-up of the two groups. Results The rate offirst-time success in observation group reached 95.1% , it was obviously higher than that in control group（76.9%, P 〈0. 05） ; The average operation time of observation group was （28.1 ± 4.2 ） seconds, significantly less than that in control group （ 33.8 ± 3. 9seconds, P 〈 0. 01 ）. Conclusions The application of FMEA in the pre-hospitallaryngeal mask implant can obviously improve the rate of first-time success and shorten the operation time for artificial-airway establishment.